Flashcards in 6 - Gynae - Disorders of the Vulva and Vagina - Carcinoma of the Vulva Deck (9):
1
age group most common in? 95% of vulval malignancies are ?
3 others that account for the rest of ca's?
>60
SCCs
BCC, adenocarcinomas, melanomas
2
aetiology - can arise from VIN or ??
also ass w lichen ? , ?, smoking and ? disease of vulva
de novo
sclerosus, immunosuppression
pagets
3
4 main clinical features
why often present late?
pruritis, bleeding, discharge, mass
lesions go unnoticed or embarrassment
4
Ex - ? or mass, mostly on labia ? or ?
inguinal ? may be enlarged, hard and ?
ulcer
majora
clitoris
LNs
immobile
5
Spread and staging - 50% presx at stage ?
vulval ca spreads ? by ? drainage of vulva > ? then ? inguinal nodes > ? > est iliac nodes
can spread contralateral - staging is ? and ?
stage 1
locally
lymph
sf
deep
femoral
surgical
histo
6
Ix - what is established with biopsy? what needed to asses fitness for surgery?
histo type/diagnosis
CXR, ECG, FBC, U+E, Cross match
7
describe staging
1 - vulva/perineum and no nodes
2 - any size, local spread, no nodes
3 - any size with positive nodes
4 - in upper urethra/vagina, rectum/bone/bladder or distant mets
8
trt - what first? then wide local ? with separate ? ? dissection, bilateral unless tumour ? from midline
? if LNs involved
biopsy
excision
groin node
>2cm
RTx
9